CNA's calling in/writing prescriptions

Nurses General Nursing

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Hello;

I have a question that I hope someone can answer for me. I work in a specialty clinic/surgery center in Wisconsin. I am an LPN.

I was at my desk this afternoon, when a nursing assistant sits down next to me; and calls in a prescription to a pharmacy for one our patients.

Since when is this legal? I have been an LPN for 30 years, and I have never worked in any facility that would allow a non-licensed staff member to call in a prescription for a patient. I watched the nursing assistant write out the prescription and had the provider sign it, as well. I was at a loss for words, quite frankly.

I spoke with one of the clinic managers about what I had just witnessed; and her response was " well; I am not sure what the policy is of this clinic--I don't think that MA's/CNA's are suppposed to be doing that."

If nursing assistants can write/call in medications to pharmacies-then why did I bother going to nursing school?

I want to know what is legal in the state of Wisconsin---the last thing I want, is to have the State come back into this clinic and shut us down for violations/infractions.

All comments are apprecicated!

Phelan 26 in Wisconsin

Specializes in Peds, ER/Trauma.

I am from WI, and while I was in nursing school, was a certified pharmacy technician. As far as I know, it is OK for a CNA to write a prescription out as long as the Dr. signs it, BUT, I don't think they are allowed to CALL prescriptions in.

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Specializes in CNA.

From what I was taught, it's not legal. But then again, it could be different in the state your livining in.

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Interesting range of views. I wonder if there's actually any law specifically relating to this? I kind of doubt it, to be honest. It is my understanding that anything a physician tasks out and signs for is the same as if he/she did it.

We frequently have medical students write orders, sign notes, and do procedures, and they are not holding any kind of license. All perfectly legal as long as the person with the MD ultimately signs personally.

If anyone has any specific knowledge about the law in this example, I'd be very interested to see a citation.

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Specializes in nursery, L and D.

In NC any person authorized by the doc (in a doctors office) can call in scipts, give orders to nurses calling from hospital/LTC, etc. They work under the doctors license, so the BON says it is OK.

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I have done this where I work, i work in a mentla health clinic, and the docs and NP's have asked me to call in Rx, our LPN's usually do that, but if we are in a bind or the LPN's are super busy I have done it for them.

I also do all the AIMS testing on patients who are taking haldol and Risperadol shots. I had a basic 1 hour crash course in AIMS testing. I'm still not real comfortable doing that, but they say I'm fine to do it.

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Specializes in Labor & Delivery.
In NC any person authorized by the doc (in a doctors office) can call in scipts, give orders to nurses calling from hospital/LTC, etc. They work under the doctors license, so the BON says it is OK.

Not to stir anyone's pot BUT...this kind of thing really gripes me. I worked hard for my nursing education and feel that with education comes the right to provided certain tasks that require that education to perform. So just anyone can walk into an office, become employed, and perform nursing tasks? WOW...and to think i suffered through psych/mental health for a whole semester writing scientific care plans and interpersonal assessments when I could have just worked at a DR. office? Well...no offense to those of you who are reading this that work in an MD office. I just feel protective of my title as a nurse. Those folks in the offices that call themselves "nurses" are a whole other ball of wax which I wont address in this rant!:eek:

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Not to stir anyone's pot BUT...this kind of thing really gripes me. I worked hard for my nursing education and feel that with education comes the right to provided certain tasks that require that education to perform. So just anyone can walk into an office, become employed, and perform nursing tasks? WOW...and to think i suffered through psych/mental health for a whole semester writing scientific care plans and interpersonal assessments when I could have just worked at a DR. office? Well...no offense to those of you who are reading this that work in an MD office. I just feel protective of my title as a nurse. Those folks in the offices that call themselves "nurses" are a whole other ball of wax which I wont address in this rant!:eek:

i understand where you arwe coming from and I would feel the same way too if I were a nurse. But as a CNA there are some things I do that I dont' feel comfortbale doing and when I questioned it I was told I was allowed to do that and therefore it is part of my job. I don't feel that it is within my scope but what can i do? Boss tells me it is. I feel it's not.

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Specializes in Labor & Delivery.
i understand where you arwe coming from and I would feel the same way too if I were a nurse. But as a CNA there are some things I do that I dont' feel comfortbale doing and when I questioned it I was told I was allowed to do that and therefore it is part of my job. I don't feel that it is within my scope but what can i do? Boss tells me it is. I feel it's not.

Even as a nurse I am not comfortable doing something that is new to me. Certainly if I felt it wasnt within my scope of practice I would refuse. We have physicians that will try to have us perform task that arent within the RN's scope of practice. I always tell them it isnt something I am allowed to do. If it is within my scope and i'm uncomfortable with the task i'll ask a more experienced co-worker to walk me through it.

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I worked with a CNA who had previously been permitted to do all kinds of things (give injections, call in scripts, do pt education, etc.) when she worked in a small town doc's office. After she went to work in our nurses only-no docs clinic, we could not get it through her head that a doc can legally delegate certain tasks to her that nurses can't- and don't want to.

She fancied herself "as good as any RN." I would overhear her pt "teaching" which consisted mainly of old wives tales and urban legends.

She would even physically insert herself between me and my pts when I was speaking to them- in order to "correct" me. Mgmt was impotant.

Needless to say, I was outta' there. Nurse turnover at the clinic remains at approx 200% annually, but the same CNAs have been there for years and years.

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Even as a nurse I am not comfortable doing something that is new to me. Certainly if I felt it wasnt within my scope of practice I would refuse. We have physicians that will try to have us perform task that arent within the RN's scope of practice. I always tell them it isnt something I am allowed to do. If it is within my scope and i'm uncomfortable with the task i'll ask a more experienced co-worker to walk me through it.

Oh yeah I have done that, I just feel really uncomfortable doing AIMS testing on patients here, mostly because I am so unfamiliar with it and I relly dont' know exactly what to look for and when i have questions about it I will ask about it and have a LPN or my super do a AIMS test to just to make sure I have done it right.

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I worked with a CNA who had previously been permitted to do all kinds of things (give injections, call in scripts, do pt education, etc.) when she worked in a small town doc's office. After she went to work in our nurses only-no docs clinic, we could not get it through her head that a doc can legally delegate certain tasks to her that nurses can't- and don't want to.

She fancied herself "as good as any RN." I would overhear her pt "teaching" which consisted mainly of old wives tales and urban legends.

She would even physically insert herself between me and my pts when I was speaking to them- in order to "correct" me. Mgmt was impotant.

Needless to say, I was outta' there. Nurse turnover at the clinic remains at approx 200% annually, but the same CNAs have been there for years and years.

You were dealing with someone who would have had practice issues no matter where she was employed, Val. There may have been a difference in how this person would have been dealt with under a different employer. Obviously this is a clinic that doesn't care that their turnover with nurses is 200% annually, otherwise something would have been done. Obviously this is a clinic that doesn't value the safety of the patients they treat, otherwise something would have been done about unqualified and uneducated CNAs dispensing inaccurate advice/health teaching or practicing outside their boundaries. Management chose to be impotent. If this person was actually certified as a CNA, than you and the other other nurses would have had a recourse through your SBON. If not, you would have had recourse through the agencies that license the clinic.

Originally Posted by crissrn27

In NC any person authorized by the doc (in a doctors office) can call in scipts, give orders to nurses calling from hospital/LTC, etc. They work under the doctors license, so the BON says it is OK.

It's not the BON that's saying it's OK or that they're even OK with what is going on. They have no jurisdiction over it. They don't have authority over MDs nor staff they employ unless that staff is licensed or certified by them. SBONs strictly govern the licenses and certification of nurses and CNAs. They don't govern the practices of health care facilities or physicians. Between the AMA and state legislature, this is how this practice has become permissible.

Nurses don't have to accept orders from unqualified, unlicensed personnel and pharmacies shouldn't. I won't.

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